Durable medical equipment is a type of medical equipment that your doctor orders for medical reasons. Examples of durable medical equipment are walkers, wheelchairs, and hospital beds.
Equipment covered by Blue Shield Promise Medicare plan
Covered items include, but are not limited to
- Hospital bed
- IV infusion pump
- Oxygen equipment
Generally, Blue Shield of California Promise Health Plan covers any durable medical equipment covered by Original Medicare from the brands and manufacturers on our list. We will not cover other brands and manufacturers unless your doctor or other provider tells us that the brand is appropriate for your medical needs.
Information for new Blue Shield of California Promise Health Plan members
If you are new to Blue Shield of California Promise Health Plan and are using a brand of durable medical equipment that is not on our list, we will continue to cover this brand for you for up to 90 days. During this time, you should talk with your doctor to decide what brand is medically appropriate for you after this 90-day period. (If you disagree with your doctor, you can ask him or her to refer you for a second opinion.)
Plan coverage decision
If you (or your provider) don’t agree with Blue Shield of California Promise Health Plan’s coverage decision, you, your representative, or your provider may file an appeal. You can also file an appeal if you don’t agree with your provider’s decision about what product or brand is appropriate for your medical condition.
For more information about appeals, see Chapter 9 of your Evidence of Coverage, What to do if you have a problem or complaint (coverage decisions, appeals, complaints).
NOTE: Authorization rules for services may apply. For details, call Member Services:
Phone:(800) 544-0088 [TTY: 711], 8 a.m. – 8 p.m., seven days a week from October 1 through March 31, and 8 a.m. – 8 p.m., weekdays from April 1 through September 30.